10.2190/0009-9E12-HT6D-3J13 00099E12HT6D3J13 313 SELF-MANAGEMENT IN ONLINE SELF-HELP GROUPS FOR BREAST CANCER PATIENTS: FINDING THE RIGHT GROUP, A SPECULATIVE HYPOTHESIS 313 328 20060201 20060201 20060201 20060201 00099E12HT6D3J13.pdf http://baywood.metapress.com/link.asp?target=contribution&id=00099E12HT6D3J13 4 MORTON A. LIEBERMAN University of California, San Francisco A common strategy to maximize the effectiveness of psychotherapy is patient placement to a particular form or type of psychotherapy. Six online self-directed breast cancer groups (N = 114) were studied to explore the speculative hypothesis that participants select the particular group that best fits their needs. All the groups encouraged "lurking," reading the postings before joining. Seventy-four percent lurked, half of them for about a week, the other half from two to eight weeks. Forty-eight percent shopped for "the right fit" by trying out other Internet BC groups. We found that: 1) pre-post measures (six months) show substantial improvement; 2) analysis of between groups differences in outcomes was not significant; and 3) analysis of processes linked to positive outcomes (Helpful Group Experiences and negative emotional expression) differed among the groups. The findings may be explained by the prospective members' ability to sample a variety of groups and to select the one that they believe will be the most comfortable and helpful to them. Lieberman, M. A., & Russo, S. (2001-2002). Self help groups and the Internet: Breast cancer newsgroups. International Journal of Self Help & Self Care, 1(4), 323-344. Litt, M. D., Babor, T. F., DelBoca, R., & Kadden, M. (1992). Types of alcoholics: II. Application of an empirically derived typology to treatment matching. Archives of General Psychiatry, 49(8), 609-614. Mohr, D., Shoham-Salomon, V., Engle, D., & Beuiler, L. E. (1991). Anger in focused expressive psychotherapy: Its measurement and role. Psychotherapy Research, 1, 125-135. McCallum, M., Piper, W. E., & Morin, H. (1995). Affect and outcome in short-term group therapy for loss. International Journal of Group Psychotherapy, 43, 303-318. Nonnecke, B. (2000). Lurking in email-based discussion lists. Unpublished Ph.D. dissertation, South Bank University, London. Nonnecke, B., & Preece, J. (2001). Why lurkers lurk. Paper presented at the Americas Conference on Information Systems, Boston. Lieberman, M. A., Yalom, I. D., & Miles, M. B. (1973). Encounter groups: First facts. New York: Basic Books. Maloney-Krichmar, D. (2003). The meaning of an online health community in the lives of its members: Roles, relationships and group dynamics. Ph.D. thesis, University of Maryland Baltimore County, Baltimore, MD. Nonnecke, B., & Preece, J. (2000). Lurker demographics: Counting the silent. Paper presented at the ACM CHI 2000 conference on human factors in computing systems, The Hague. Maloney-Krichmar, D., & Preece, J. (2003). Which factors facilitate effective and meaningful support of members of an online health community?: A multilevel analysis of social ability, usability and community dynamics (unpublished). Kuehner, C., Angermeyer, M. C., & Veiel, H. O. F. (1996). Cognitive-behavioral group intervention as a means of tertiary prevention in depressed patients: Acceptance and short-term efficacy. Cognitive Therapy & Research, 20(4): 391-409. Lieberman, M. A., & Borman, L. (1979). Self help group for coping with crises. San Francisco: Jossey-Bass. Lieberman, M. A., Golant, M., Giese-Davis, J., Winzlenberg, A., Benjamin, H., Humphreys, K., Kronenwetter, C., Russo, S., & Spiegel, D. (2003). Electronic support groups for breast carcinoma. Cancer, 97, 920-925. Katz, J., & Aspden, P. (1998). Internet dropouts in the USA: The invisible group. Telecommunication Policy, 22, 327-339. King, S. A. (1994). Analysis of electronic support groups for recovering addicts. Interpersonal Computing and Technology: An Electronic Journal for the 21st Century, 2(3), 47-56. Koch, H. C. (1983). Correlates of changes in personal construing members of two psychotherapy groups: Changes in affective expression. British Journal of Medical Psychology, 56, 323-327. Lieberman, M. A., & Goldstein, B. A. (in press). Self help online: An outcome evaluation of breast cancer bulletin boards. Journal of Health Psychology. Spiegel, D., & Kimerling, R. (2001). Group psychotherapy for women with breast cancer: Relationships among social support, emotional expression, and survival. In C. D. Ryff & B. H. Singer (Eds.), Emotion, social relationships, and health. Series in affective science. London: Oxford University Press. Smith, M. A., & Kollock, P. (1999). Communities in cyberspace. London: Routledge. Spiegel, D., Bloom, J. R., & Yalom, I. (1981). Group support for patients with metastatic cancer. A randomized outcome study. Archives of General Psychiatry, 38, 527-533. Zettle, R. D., & Herring, E. L. (1995). Treatment utility of the sociotropy/autonomy distinction: Implications for cognitive therapy. Journal of Clinical Psychology, 51(2), 280-289. Classen, C., Butler, L. D, Koopman, C., Miller, E., DiMiceli, S., Giese-Davis, J., Fobair, P., Carlson, R. W., Kraemer, H. C., & Spiegel, D. (2001). Supportive-expressive group therapy and distress in patients with metastatic breast cancer. Archives of General Psychiatry, 58, 494-501. Goodwin, P. J., Leszcz, M., Ennis, M., Koopmans, J., Vincent, L., Guther, H., Drysdale, E., Hundleby, M., Chochinov, H. M., Navarro, M., Speca, M., & Hunter, J. (2001). The effect of group psychosocial support on survival in metastatic cancer. Cella, D., Tulsky, D., & Gray, G. (1993). The functional assessment of cancer therapy (FACT) scale: Development and validation of the general measure. Journal of Clinical Oncology, 11, 570-579. Beaudouin, V., & Velkovska, J. (1999, January 22-24). The Cyberians: An empirical study of sociality in a virtual community. Paper presented at the Ethnographic Studies in Real and Virtual Environments: Inhabited Information Spaces and Connected Communities Conference, Edinburgh. Beutler, L. E., Machado, P. P., Engle, D., & Mohr, D. (1993). Differential patient treatment maintenance among cognitive, experiential, and self-directed psychotherapies. Journal of Psychotherapy Integration, 3(1), 15-31. Winzlenberg, A., Classen, C., Roberts, H., Alpers, G., Dev, G., Koopman, C., Adams, R., & Taylor, C. B. (2003). An evaluation of a Web-based support group for women with primary breast cancer. Cancer, 97(5), 1164-1173. Radloff, L. S. (1977). The CES-D Scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385-401. Parks, R. M., & Floyd, K. (1994). Making friends in cyberspace. Journal of Computer-Mediated Communication, 1(4). Available from: http://www.ascusc.org/jcmc/vol1/issue4/parks.html . Piper, W. E., McCallum, M., Joyce, B., Rosie, L., & Ogrodniczuk, M. (2001). Patient personality and time-limited group psychotherapy for complicated grief. International Journal of Group Psychotherapy, 51(4), 525-552. Preece, J. (1999). Empathic communities: Balancing emotional and factual communication. Interacting with Computers, The Interdisciplinary Journal of Human-Computer Interaction, 12(1), 63-77. Walther, J., & Boyd, S. (2002). Attraction to computer-mediated social support. In C. Lin & D. Atkin (Eds.), Communication technology and society: Audience adoption and use (pp. 153-188). Cresskill, NJ: Hampton Press. Abras, C. (2003). Determining success in online education and health communities. PhD thesis, University of Baltimore County Maryland, Baltimore, MD. Lieberman, M. A. (1990). Understanding how groups work: A study of homogenous peer group failures. International Journal of Group Psychotherapy, 40(1), 31-52. Gottschalk, L. A. (2000). The application of computerized content analysis of natural language in psychotherapy research now and in the future. American Journal of Psychotherapy, 54, 305-311. Greenberg, L. S., & Forester F. S. (1996). Task analysis exemplified: The process of resolving unfinished business. Journal of Consulting and Clinical Psychology, 64, 439-446. Greenberg, L. S., & Webster, M. C. (1982). Resolving decisional conflict by Gestalt two-chair dialogue: Relating process to outcome. Journal of Counseling Psychology, 29, 468-477. Kaminer, Y., Burleson, J. A., Blitz, C., Sussman, J., & Rounsaville, B. (1998). Psychotherapies for adolescent substance abusers: A pilot study. Journal of Nervous & Mental Disease, 186(11), 684-690. Mason, B. (1999). Issues in virtual ethnography. Paper presented at the Ethnographic studies in real and virtual environments: Inhabited information spaces and connected communities conference, Edinburgh. Tedeschi, R., & Calhoun, L. (1996). The posttraumatic growth inventory: Measuring the positive legacy of trauma. Journal of Traumatic Stress, 9, 455-469. Yalom, I. D. (1985). The theory and practice of group psychotherapy (3rd ed.). New York: Basic Books.